title: Prevalence of Chlamydia trachomatis among young German adolescents, 2005-06.
abstract: BACKGROUND
  Chlamydia trachomatis prevalence among 12-17-year-old adolescents in Germany was determined in the present study.
  
  
  METHODS
  A random age-stratified sample of 1815 urine specimens of boys and girls was selected from a population-based nationwide health survey conducted in 2003-06. Urine samples were pooled and tested for chlamydia using strand displacement amplification. Positive pools were individually retested. Prevalence, prevalence ratios (PR) and corresponding 95% confidence intervals (CI) were calculated. Associations between infection and socio-demographic factors (age, sex, place of residence), sexual activity (defined by oral contraceptive use or gynaecologist visits) and abdominal pain among females were examined in univariate analysis.
  
  
  RESULTS
  Sixteen samples (0.9% 95% CI: 0.5-1.3%), all from 15-17-year olds, were positive for chlamydia. Prevalence increased with age to 2% (95% CI: 0.8-3.2%) among 17 year olds and was higher among girls than boys (1.8% v. 0.1%; P < 0.001). A total of 4.6% (95% CI: 1.4-7.7%) of sexually active girls aged 17 were infected and 5/7 of them had no regular abdominal pain. Of all girls with abdominal pains, 52% had visited gynaecologists. Prevalence of infection was higher among those with pains than those without (PR = 3.8, 95% CI: 1.3-11.0).
  
  
  CONCLUSIONS
  This is the first nationwide study based on a representative sample of boys and girls to measure chlamydia prevalence among adolescents in Germany. Prevalence in Germany is consistent with other countries. Among sexually active females, prevalence was comparable to screening thresholds. As gynaecological visits were common among females, we recommend that gynaecologists should actively offer screening to sexually active females, which would strengthen the newly implemented screening for females under 25 years.
authors.affiliation: Robert Koch Institute, Department for Infectious Disease Epidemiology, Seestraße 10, 13353 Berlin, Germany.
authors.forename: Sarika
authors.initials: S
authors.lastname: Desai
authors.forename: Thomas
authors.initials: T
authors.lastname: Meyer
authors.forename: Michael
authors.initials: M
authors.lastname: Thamm
authors.forename: Osamah
authors.initials: O
authors.lastname: Hamouda
authors.forename: Viviane
authors.initials: V
authors.lastname: Bremer
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000652:urine; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D016001:Confidence Intervals; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners / Q000523:psychology; D012959:Socioeconomic Factors